Police Report No. (if applicable):

Plaintiff(s)/Petitioner(s) Defendant(s)/Respondent(s) People of the State of Michigan v

Civil Criminal Charge

Probate In the matter of

In the Name of the People of the State of Michigan. TO:

If you require special accommodations to use the court because of disabilities, please contact the court immediately to make arrangements.

YOU ARE ORDERED TO:

1. Appear personally at the time and place stated below: You may be required to appear from time to time and day to day until excused.

The court address above Other:

Day Date Time

2. Testify at trial / examination / hearing.

3. Produce/permit inspection or copying of the following items:

4. Testify as to your assets, and bring with you the items listed in line 3 above.

5. Testify at deposition.

6. Abide by the attached prohibition against transferring or disposing of property. (MCL 600.6104(2), 600.6116, or 600.6119.)

7. Other: Person requesting subpoena Telephone no. 8. Address

City State Zip

NOTE: If requesting a debtor's examination under MCL 600.6110, or an injunction under item 6. this subpoenamust be issued by a judge. For a debtor examination, the affidavit of debtor examination on the other side of thisform must also be completed. Debtor's assets can also be discovered through MCR 2.305 without the need foran affidavit of debtor examination or issuance of this subpoena by a judge.

FAILURE TO OBEY THE COMMANDS OF THE SUBPOENA OR TO APPEAR AT THE STATED

TIME AND PLACE MAY SUBJECT YOU TO PENALTY FOR CONTEMPT OF COURT. Court use only Served Not servedDate Judge/Clerk/Attorney Bar no.

PROOF OF SERVICE Case No.

TO PROCESS SERVER: You must make and file your return with the court clerk. If you are unable to complete service, you mustreturn this original and all copies to the court clerk.

CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE

OFFICER CERTIFICATE OR AFFIDAVIT OF PROCESS SERVER

I certify that I am a sheriff, deputy sheriff, bailiff, appointed Being first duly sworn, I state that I am a legally competent court officer, or attorney for a party [MCR 2.104(A)(2)], and adult who is not a party or an officer of a corporate party, and that: (notarization not required) that: (notarization required)

I served a copy of the subpoena, together with (including any required fees) by Attachment personal service registered or certified mail (copy of return receipt attached) on: Name(s) Complete address(es) of service Day, date, time

I have personally attempted to serve the subpoena and required fees, if any, together with on the following person(s) and have been unable to complete service. Attachment

Name(s) Complete address(es) of service Day, date, time

Service fee Miles traveled Fee Signature

$ $Incorrect address fee Miles traveled Fee TOTAL FEE Name (type or print)

$ $ $ TitleSubscribed and sworn to before me on , County, Michigan. DateMy commission expires: Signature: Date Deputy court clerk/Notary publicNotary public, State of Michigan, County of ACKNOWLEDGMENT OF SERVICEI acknowledge that I have received service of the subpoena and required fees, if any, together with Attachment

on Day, date, time

on behalf of .Signature

AFFIDAVIT FOR JUDGMENT DEBTOR EXAMINATION

I request that the court issue a subpoena that orders the party named on this form to be examined under oath before a judge concerning the money or property of: for the following reasons:

SignatureSubscribed and sworn to before me on , County, Michigan. DateMy commission expires: Signature: Date Deputy court clerk/Notary publicNotary public, State of Michigan, County of